Healthcare Policy, 21(3) May 2026.doi:10.12927/hcpol.2026.27800
A Population-based Comparison of Wait-times for Common Elective General Surgery Procedures between Immigrants and Non-Immigrants in British Columbia.
Michael Y. Guo, Christine Li, Ahmer A. Karimuddin and Jason M. Sutherland
Background:
Long wait-times for elective surgery represent a persistent challenge in healthcare systems and waiting patients, particularly in Canada. Delays to elective surgery impact patient well-being but may also disproportionately affect vulnerable populations. Despite high levels of immigration to Canada, research regarding immigrants’ access to elective surgical care remains scarce. This population-based study measures and compares wait-times for common elective general surgeries for immigrants with non-immigrants in British Columbia (B.C.), Canada.
Methods:
All elective general surgery procedures performed in B.C., Canada between 2013 and 2021 were identified using hospital discharge summaries’ procedure codes. A longitudinal cohort was created by linking cohort members with immigration and physician billing data. Patients’ wait-time was defined as the duration between the last general surgery visit and surgery date. Wait times were compared between immigrants and non-immigrants adjusting for patient- and system-level factors using multivariable regression.
Results:
Among 159,151 elective general surgeries, 14.3% were performed on immigrants. Immigrants experienced longer wait-times on average compared with non-immigrants (83.7 versus 76.3 days), a difference that remained significant after adjustment (RR: 1.03, 95%CI: 1.01-1.05). Differences were most pronounced for cholecystectomies; immigrants waited 15.4 days longer on average (unadjusted) than non-immigrants. Among immigrants, ‘visible minorities’ waited longer compared with immigrants from European/English-Speaking countries (RR: 1.06, 95%CI: 1.03-1.10).
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